Brain injury, medical progress, and the disability paradox: Towards an Americans with Abilities Act.

It is helpful to think about the needs of patients with moderate to severe brain injury through the lens of disability law. However, there are limitations to current disability law that contribute to ongoing segregation and marginalization of individuals with severe brain injury. Indeed, one of the paradoxes of American jurisprudence is that more clear constitutional protections accrue to those who have definitively immutable conditions. Thus, as neuroscience brings new therapies to those with brain injury, they may become less protected by the constitutional elements of disability law because their conditions have changed and become mutable. This is the clinical progress that brain injury professionals all seek to achieve, but ironically these advances could potentially degrade the legal protections of patients who benefit from emerging treatments. In this paper, we will critically examine this paradox at the interface of medicine and the law and suggest that the Americans with Disabilities Act (ADA) could be nicely complemented by legislation we have named the Americans with Abilities Act (AWAA). Instead of focusing on disabilities that need protection, the AWAA seeks to sustain and foster newfound abilities made possible by the fruits of medicine and neuroscience.

Adicciones y discapacidad: medidas adoptadas por la legislación para la protección en el ámbito personal y patrimonial / Addictions and disability: measures adopted by legislation for protection in the personal and property sphere

La adicción a medicamentos, alcohol o drogas puede provocar en la persona una discapacidad. En la actualidad, la legislación se ha orientado a adoptar una serie de medidas de apoyo para proteger a las personas con discapacidad, sea cual sea el motivo que les haya llevado a dicha situación, tanto en el ámbito personal como patrimonial. Ya no se habla de la incapacitación en la norma, y sí de diversas medidas a adoptar tanto en la Ley 41/2003, de 18 de noviembre, de protección patrimonial de las personas con discapacidad y de modificación del Código Civil, de la Ley de Enjuiciamiento Civil y de la Normativa Tributaria con esta finalidad, como en la Ley 8/2021, de 2 de junio, por la que se reforma la legislación civil y procesal para el apoyo a las personas con discapacidad en el ejercicio de su capacidad jurídica. Dentro de estas medidas hay que diferenciar a la persona menor y al mayor de edad. El propósito de este estudio es analizar dichas medidas en relación con la discapacidad y la adicción, bien cuando la adicción determina una situación de discapacidad, como cuando la persona discapacitada tiene una adicción posterior con la finalidad de proteger tanto a la persona como a los bienes. (AU)

Addiction to medication, alcohol or drugs can cause a person to become disabled. Currently, legislation has been aimed at adopting a series of support measures to protect people with disabilities, whatever the reason that has led them to this situation, both in the personal and property spheres. The law no longer talks about incapacitation, but rather about various measures to be adopted both in Law 41/2003, of November 18, on the property protection of people with disabilities and on the modification of the Civil Code, the Law of Civil Prosecution and Tax Regulations for this purpose. as in Law 8/2021, of June 2, which reforms civil and procedural legislation to support people with disabilities in the exercise of their legal capacity. Within these measures, it is necessary to differentiate between the minor and the adult. The purpose of this study is to analyze these measures in relation to disability and addiction, either when the addiction determines a situation of disability, or when the disabled person has a subsequent addiction in order to protect both the person and the property. (AU)

La figura de facilitación de acceso a la justicia. Comparación internacional de un reto formativo / Intermediaries in Access to Justice. International Comparison of a Training Challenge

El facilitador es un profesional que posibilita el ejercicio del derecho de acceso a la justicia a las personas con discapacidad intelectual y del desarrollo, favoreciendo los principios de equidad, participación, accesibilidad y autodeterminación. En el presente estudio, se realiza una revisión bibliográfica para determinar la presencia de esta figura en el panorama internacional y su perfil formativo. En el derecho internacional, actualmente, podemos encontrarla en algunos países nórdicos, Reino Unido, Israel, Azerbaiyán, Taiwán, Sudáfrica, Kenia, Canadá, varios estados de EE. UU., México y Chile, así como en parte del territorio australiano y Nueva Zelanda. En España, la figura aparece en la última reforma de la legislación civil y procesal (Ley 8/2021, de 2 de junio). En su perfil formativo encontramos tanto la educación formal como no formal de estos profesionales. El perfil del facilitador habrá de ajustarse a las necesidades de las personas con discapacidad intelectual y del desarrollo y del contexto que requiera la facilitación. (AU)

Intermediaries are professionals who enable the effective right of access to justice for people with intellectual and developmental disabilities, ensuring principles of equity, participation, accessibility and self-determination for them. This paper analyzes the presence and formative background of this figure from an international comparative perspective. Nowadays, we can find these professionals in the international law across different countries: some Nordic countries, United Kingdom, Israel, Azerbaijan, Taiwan, South Africa, Kenya, Canada, part of the USA, Mexico and Chile, Australia and New Zealand. In Spain, intermediaries are considered in the latest reform of the civil and procedural legislation (Law 8/2021, June the 2nd). This paper analyzes the formative background of this figure from an international comparative perspective. We find both formal and non-formal education in the background of these professionals. There is no doubt their profile must adjust to the needs of people with intellectual and developmental disabilities and the contexts that require the facilitation. (AU)

El trabajo social y sus intervenciones de apoyo a la capacidad jurídica de las personas, tras la Ley 8/2021 / Social Work and its Interventions to Support the Legal Capacity of People, after Law 8/2021

La relación del trabajo social con la Administración de Justicia adquiere una nueva dimensión en el campo de la discapacidad. La Ley 8/2021, por la que se reforma la legislación civil y procesal para el apoyo a las personas con discapacidad en el ejercicio de su capacidad jurídica, reconoce la importancia de esta profesión y la sitúa junto a la profesión médica en cuánto a la información pericial y la intervención a realizar con personas con discapacidad. La cuestión de los apoyos para mejorar la capacidad jurídica es una variable fundamental para que la valoración sociofamiliar sea necesaria. La aportación de este estudio es descriptiva y propositiva, sitúa la ley en relación con la situación social y con la profesión del trabajo social. Posteriormente, detalla las disciplinas o especialidades del trabajo social que pueden participar en estos procedimientos judiciales, con ejemplos de relaciones previas entre la regulación de la discapacidad y el trabajo social. Finalmente, realiza una propuesta de trabajo, un inicio de protocolo de actuación entre disciplinas para buscar la colaboración en forma de mesa redonda que recoge la ley. (AU)

The relationship between social work and the administration of justice acquires a new dimension in the field of disability. Law 8/2021, which reforms civil and procedural legislation to support people with disabilities in the exercise of their legal capacity, recognizes the importance of this profession and places it on a par with the medical profession in terms of expert information and intervention to be carried out with people with disabilities. The question of support to improve legal capacity is a fundamental variable for the socio-family assessment to be necessary. The contribution of this study is descriptive and propositional; it places the law concerning the social situation and the profession of social work. Subsequently, it details the disciplines or specialties of social work that can participate in these judicial proceedings, with examples of previous relationships between the regulation of disability and social work. Finally, it makes a work proposal, a beginning of the protocol of action between disciplines to seek collaboration in the form of a round table that includes the law. (AU)

Aprendiz com deficiência

Cartilha sobre questões de pessoas com necessidades especiais.

De la modificación de la capacidad a la provisión de apoyos en personas con discapacidad / From capacity modification to support measures in people with disabilities

No disponible

Brazilian law of inclusion: an applied analysis of the correlation of bioethical principles / Ley brasileña de inclusión: un análisis aplicado de la correlación de los principios de la bioética / Lei brasileira de inclusão: uma análise aplicada da correlação dos princípios de bioética

Abstract: Objective: The present study aims to analyse whether bioethical principles are present in the Brazilian Law of Inclusion of the Disabled Person. Methods: The study is based on a textual analysis of Law No. 13.146, of July 6, 2015 (Brazilian Law of Inclusion) using a content analysis technique regarding the bioethical principles of beneficence, nonmaleficence, justice and autonomy. A qualitative analysis was conducted based on the concepts of these bioethical principles and their expression in the articles laid down in the Statute of the Disabled Person. Results: The obtained results demonstrate that the primary articles of the Brazilian Law of Inclusion correlate with the aforementioned bioethical principles according to the conceptualisation of each principle. Conclusion: The articles of the Brazilian Law of Inclusion, published on July 6, 2015, under the provisions of the Federal Constitution of 1988 and the Convention on the Rights of Persons with Disabilities, demonstrate a correlation with the stated bioethical principles.

Resumen: Objetivo: El presente estudio pretende analizar si los principios bioéticos están presentes en la Ley brasileña de inclusión de personas con discapacidad. Métodos: El estudio se basa en un análisis textual de la Ley nº 13.146 de 6 de julio de 2015 (Ley brasileña de inclusión) mediante una técnica de análisis de contenido sobre los principios bioéticos de beneficencia, no maleficencia, justicia y autonomía. Se realizó un análisis cualitativo basado en los conceptos de estos principios bioéticos y su expresión en los artículos establecidos en el Estatuto del Discapacitado. Resultados: Los resultados obtenidos muestran que los artículos primarios de la Ley de Inclusión brasileña se correlacionan con los principios bioéticos mencionados, según la conceptualización de cada principio. Conclusión: Los artículos de la Ley de Inclusión brasileña, publicada el 6 de julio de 2015, en virtud de las disposiciones de la Constitución Federal de 1988 y de la Convención sobre los Derechos de las Personas con Discapacidad, demuestran una correlación con los principios bioéticos enunciados.

Resumo: Objetivo: O presente estudo tem por objetivo analisar se os princípios bioéticos estão presentes na Lei Brasileira de Inclusão da Pessoa com Deficiência. Métodos: O estudo é baseado em uma análise textual da Lei nº 13.146, de 6 de julho de 2015 (Lei Brasileira de Inclusão) utilizando uma técnica de análise de conteúdo relativa aos princípios bioéticos de beneficência, não maleficência, justiça e autonomia. Uma análise qualitativa foi realizada com base nos conceitos destes princípios bioéticos e sua expressão nos artigos estabelecidos no Estatuto da Pessoa Deficiente. Resultados: Os resultados obtidos demonstram que os artigos primários da Lei de Inclusão brasileira se correlacionam com os princípios bioéticos acima mencionados, de acordo com a conceituação de cada princípio. Conclusão: Os artigos da Lei Brasileira de Inclusão, publicados em 6 de julho de 2015, sob as disposições da Constituição Federal de 1988 e da Convenção sobre os Direitos das Pessoas com Deficiência, demonstram uma correlação com os princípios bioéticos declarados.

Federal Incentives to Reform Long-Term Care Under the Affordable Care Act: State Adoption of the Balancing Incentive Program, 2011-2014.

OBJECTIVES: The Balancing Incentive Program (BIP) was an optional program for states within the Patient Protection and Affordable Care Act to promote Medicaid-funded home and community-based services (HCBS) for older adults and persons with disabilities. Twenty-one states opted to participate in BIP, including several states steadfastly opposed to the health insurance provisions of the Affordable Care Act. This study focused on identifying what factors were associated with states' participation in this program. METHODS: Event history analysis was used to model state adoption of BIP from 2011 to 2014. A range of potential factors was considered representing states' economic, political, and programmatic conditions. RESULTS: The results indicate that states with a higher percentage of Democrats in the state legislature, fewer state employees per capita, and more nursing facility beds were more likely to adopt BIP. In addition, states with fewer home health agencies per capita, that devoted smaller proportions of Medicaid long-term care spending to HCBS, and that had more Money Follows the Person transitions were also more likely to pursue BIP. DISCUSSION: The findings highlight the role of partisanship, administrative capacity, and program history in state BIP adoption decisions. The inclusion of BIP in the Affordable Care Act may have deterred some states from participating in the program due to partisan opposition to the legislation. To encourage the adoption of optional HCBS programs, federal policymakers should consider the role of financial incentives, especially for states with limited bureaucratic capacity and that have made less progress rebalancing Medicaid long-term services and supports.

La representación del apoyo de la persona con discapacidad: el nuevo esquema de la capacidad jurídica en el Perú / The representation of the support of the person with disability: the new scheme of legal capacity in Peru / A representação do apoio à pessoa com incapacidade: o novo esquema da capacidade jurídica no Peru

Resumen Desde 2018, por el Decreto Legislativo 1384, Perú cuenta con un nuevo tratamiento de la capacidad en el Código Civil, que se adecua a las directrices en pro de la autonomía y la plena capacidad jurídica de las personas con discapacidad, concordando la legislación nacional a la Convención Internacional de los Derechos de las Personas con Discapacidad. El régimen de sustitución de la voluntad de las personas incapaces es reemplazado por un modelo social mediante apoyos y salvaguardias, un modelo inclusivo, democrático, acorde al respeto a los derechos humanos de todos los ciudadanos (dignidad e igualdad), partiendo del reconocimiento de la autonomía de la persona y su derecho a tomar sus propias decisiones, así como el derecho a equivocarse. Se desarrolla la función del apoyo en favor de la persona con discapacidad, analizando sus facultades de representación. Partimos del principio que el apoyo no reemplaza la manifestación de voluntad, solo la facilita e interpreta. Como una figura de asistencia, el apoyo colabora en una adecuada manifestación de voluntad, con el fin de que la persona con discapacidad ejerza su capacidad jurídica, disfrutando sus derechos y libertades.

Abstract Capacity is a subject of transversal interest in Law, it is present in all its fields. It is an attribute that every subject has through which he/she can perform acts that are not prohibited. Since 2018, by Legislative Decree 1384, we have a new treatment of capacity in the Civil Code that is in line with the guidelines in favor of the autonomy and full legal capacity of persons with disabilities, aligning national legislation to the International Convention on the Rights of Persons with Disabilities. The regime of substitution of the will of incapable persons is replaced by a social model through supports and safeguards. We are facing an inclusive, democratic model, according to the respect for the human rights of all citizens (dignity and equality), based on the principle that people with disabilities have full exercise capacity in equal conditions in each and every aspect of their lives, recognizing their right to make their own decisions as well as the right to make mistakes. The function of the support in favor of the disabled person is developed, analyzing their powers of representation. We start from the principle that the support does not replace the manifestation of will, it only interprets it and collaborates in an adequate manifestation of will so that the person with disability can exercise his legal capacity, enjoying his rights and freedoms.

Resumo Desde 2018, pelo Decreto Legislativo 1384, o Peru conta com um novo tratamento da capacidade no Código Civil, que se adequa às diretrizes em prol da autonomia e da plena capacidade jurídica das pessoas com incapacidade, colocando de acordo a legislação nacional com a Convenção Internacional dos Direitos das Pessoas com Incapacidade. O regime de substituição da vontade das pessoas incapazes é trocado por um modelo social mediante apoios e salvaguardas, um modelo inclusivo, democrático, de acordo com o respeito aos direitos humanos de todos os cidadãos (dignidade e igualdade), partindo do reconhecimento da autonomia da pessoa e seu direito de tomar suas próprias decisões, assim como o direito de equivocar-se. Desenvolve-se a função de apoio em favor da pessoa com incapacidade, analisando suas faculdades de representação. Partimos do princípio que o apoio não substitui a manifestação de vontade, somente a facilita e interpreta. Como uma figura de assistência, o apoio colabora para uma adequada manifestação de vontade, com ela finalidade de que a pessoa com incapacidade exerça sua capacidade jurídica, desfrutando seus direitos e liberdades.

Legislation for disabled people in Brazil: from human dignity to social inclusion: advancing capabilities as an ethical imperative / Legislación para los discapacitados en Brasil: de la dignidad humana a la inclusión social: el avance de las capacidades como imperativo ético / Legislação para os incapacitados no Brasil: da dignidade humana à inclusão social: o avanço das capacidades como imperativo ético

Abstract The study analyzes the ethical and legal basis of Brazilian legislation for people with disabilities and verifies whether the instruments used therein are in line with national and international law. It also investigates the coherence and cohesion of the law and its ethical norms to build an inclusive and just society. Through an exploratory and integrative review, it analyzed the legal provisions in force in Brazil published on the official websites of the Brazilian federal government and available on the Internet. It was evaluated whether the definition used for persons with disabilities follows the United Nations Convention on the Rights of Persons with Disabilities. Also, whether it is necessary to evaluate disabilities and who should perform this task professionally. Thirty-three legal norms were found, among which only three laws and two decrees are in line with the recommendations of the UN Convention. It is necessary to review the existing norms and promote the consolidation of laws, decrees, ordinances and normative instructions regarding the rights of persons with disabilities in a uniform manner, on an adequate technical-scientific basis. This review should be consistent with the provisions of the 1988 Federal Constitution, the International Convention on the Rights of Persons with Disabilities and the Brazilian Inclusion Law.

Resumen El estudio analiza el fundamento ético y jurídico de la legislación brasileña para las personas con discapacidad y comprueba si los instrumentos allí utilizados se ajustan al Derecho nacional e internacional. Además, investiga la coherencia y cohesión de la ley y sus normas éticas para construir una sociedad inclusiva y justa. Mediante revisión exploratoria e integrativa, analizó las disposiciones legales vigentes en Brasil publicadas en los sitios web oficiales del gobierno federal brasileño y disponibles en Internet. Se evaluó si la definición utilizada para las personas con discapacidad sigue la Convención de las Naciones Unidas sobre los Derechos de las Personas con Discapacidad. También, si es necesario evaluar las discapacidades y quién debe realizar esa tarea profesionalmente. Se encontraron 33 normas legales, entre las cuales solo tres leyes y dos decretos se ajustan a las recomendaciones de la Convención de las Naciones Unidas. Es necesario revisar las normas existentes y promover la consolidación de las leyes, decretos, ordenanzas e instrucciones normativas relativas a los derechos de las personas discapacitadas de manera uniforme, sobre una base técnico-científica adecuada. Esta revisión debe ser coherente con las disposiciones de la Constitución Federal de 1988, la Convención Internacional sobre los Derechos de las Personas con Discapacidad y la Ley de Inclusión brasileña.

Resumo O estudo analisa o fundamento ético e jurídico da legislação brasileira para as pessoas com incapacidade e comprova se os instrumentos ali utilizados se ajustam ao Direito nacional e internacional. Além disso, investiga a coerência e coesão da lei e suas normas éticas para construir uma sociedade inclusiva e justa. Mediante revisão exploratória e integrativa, analisou as disposições legais vigentes no Brasil publicadas nos sites web oficiais do governo federal brasileiro e disponíveis na Internet. Avaliou-se se a definição utilizada para as pessoas com incapacidade segue a Convenção das Nações Unidas sobre os Direitos das Pessoas com Incapacidade. Também, se é necessário avaliar as incapacidades e quem deve realizar essa tarefa profissionalmente. Se encontraram 33 normas legais, entre as quais somente três leis e dois decretos se ajustam às recomendações da Convenção das Nações Unidas. É necessário revisar as normas existentes e promover a consolidação das leis, decretos, regulamentos e instruções normativas relativas aos direitos das pessoas incapacitadas de maneira uniforme, sobre uma base técnico-científica adequada. Esta revisão deve ser coerente com as disposições da Constituição Federal de 1988, a Convenção Internacional sobre os Direitos das Pessoas com Incapacidade e a Lei de Inclusão brasileira.

Responding to the Needs of People with Disabilities in the COVID-19 Pandemic: Community Perspectives from Centers for Independent Living.

Centers for Independent Living (CILs) are federally funded, community-based organizations designed and operated by people with disabilities that provide individual and systems advocacy, peer support, information and referral, independent living skills training, and transition services throughout the U.S. and its territories. Centers for Independent Living therefore offer a rich and detailed perspective on the needs of people with disabilities during the COVID-19 pandemic. In this brief report, we summarize COVID-19-related issues raised by 144 CIL administrators and staff in a national survey conducted in April and May 2020 and discuss their research and policy implications. Respondents voiced concerns about health and safety, long-term supportive services, social isolation, and economic insecurity. In the words of one center director, "The pandemic has pulled back the curtain on the depth of need in our local disability community."

Conceptualising 'Undue Influence' in Decision-Making Support for People with Mental Disabilities.

A crucial question in relation to support designed to enable the legal capacity of people with mental disabilities concerns when support constitutes undue influence. This article addresses this question in order to facilitate the development of law and policy in England and Wales, by providing a normative analysis of the different approaches to undue influence across decisions about property, contracts, health, finances, and accommodation. These are all potential contexts for supporting legal capacity, and, in doing so, the article compares approaches to undue influence that are rarely considered together. Drawing on the UN Convention on the Rights of Persons with Disabilities, third sector and public body documents, and law in England and Wales, the analysis identifies six models that conceptualise undue influence in terms of: modes of influence; an overborne will; an inference from the situation; an overborne will understood as a mental incapacity; an overborne will in connection with vulnerability; and impaired discursive control. This final approach is a novel proposal for understanding undue influence. The analysis highlights key policy-relevant issues that distinguish the models, and generates a deliberative framework for navigating them, with the 'overborne will', 'inference-based', and 'discursive control' models identified as potentially fitting for the support context.

Gravely Disabled: The Vestigial Prong of 5150 Designations.

Effective July 1, 1972, California's Lanterman-Petris-Short Act (LPS Act) set the precedent for modern mental health commitment procedures in the U.S. named after its authors, State Assemblyman Frank Lanterman and State Senators Nicholas C. Petris and Alan Short, the LPS Act sought to "end the inappropriate, indefinite, and involuntary commitment of persons with mental health disorder"; to "provide prompt evaluation and treatment of persons with mental health disorders or impaired by chronic alcoholism"; and to "guarantee and protect public safety." Despite citing to these articles of intent, the LPS Act violates its own legislative intent through its inclusion of "gravely disabled" in its enforcement of involuntary psychiatric hold designations (also known as "5150 designations"). First, police officers are not required to make a medical diagnosis of a mental health disorder at the time of a 5150 designation; the broad scope of "gravely disabled" increases the number of persons police officers can involuntarily transport, increasing the likelihood of inappropriate and involuntary commitment of persons with mental health disorders. Second, the broad scope of "gravely disabled" produces an onslaught of 5150-designated persons (whether improperly designated or not) being sent to LPS-designated hospitals with limited resources (e.g., lack of beds and psychiatric staff); this results in patients waiting for an inordinate amount of time for a psychiatric evaluation and/or a hospital bed. Third, it is unclear whether the LPS Act sought to provide protection for the mentally ill or to provide protection from the mentally ill in its guarantee of protecting "public safety"; the inclusion of "gravely disabled" in 5150 designations indicates that the LPS Act provided the public with a duplicitous means of removing the mentally ill, impoverished, and houseless from the streets under the guise of "public safety." This Paper suggests the following to help remedy the effects of implementing the broadly defined "gravely disabled" in 5150 designations: (1) Remove "gravely disabled" from the 5150 criteria; (2) integrate the community with mental health advocacy efforts by creating outreach and education programs; and (3) implement a client-centric approach to interacting with persons with mental health disorders through restorative policing and the establishment of a restorative court.